小剂量沙利度胺组合方案治疗老年克罗恩病的临床观察

Clinical Observation of the Combined Regimen of Low-dose Thalidomide in the Treatment of Crohn's Disease in the Elderly

中文关键词: 老年  克罗恩病  沙利度胺  英夫利昔单抗  硫唑嘌呤

英文关键词: elderly  Crohn's disease (CD)  thalidomide (THD)  infliximab (IFX)  azathioprine (AZA)

中文摘要:

      目的 探讨小剂量沙利度胺(THD)组合方案治疗老年克罗恩病(CD)的疗效及安全性.方法 回顾性分析37例应用小剂量THD治疗的老年CD患者的临床资料,分为观察组(力=32)和对照组(n=5).观察组接受小剂量THD组合方案治疗,对照组只接受THD单独治疗(THD组).观察组又分为3个亚组:THD+激素组(n=13)、THD+英夫利昔单抗(IFX)组(n=12)和THD+硫唑嘌呤(AZA)组(n=7).评价与比较各组诱导缓解率、黏膜愈合率、不良反应发生率及其严重程度.结果 THD组、THD+AZA、THD+激素组和THD+IFX组的临床缓解率分别为40.0％、53.8％、66.7％、71.4％;黏膜愈合率分别为20.0％、23.1％、16.7％、28.6％;不良反应发生率分别为60.0％、92.3％、83.3％、71.4％.结论 小剂量THD组合方案中,THD+ IFX组疗效最佳,同时未明显增加THD不良反应;激素及AZA可提高THD疗效,但同时增加不良反应.

英文摘要:

      Objective To explore the curative effect of the combined regimen of low-dose thalidomide (THD) on the elderly with Crohn's disease (CD) and its safety.Methods A retrospective analysis was made to the clinical data of 37 CD elderly treated with low-dose THD;they were divided into 2 groups:observation group (n=32) and control group (THD group) (n=5),the combined regimen of low-dose THD was applied to cases in observation group while THD was signally administrated to cases in control group;the observation group was further divided into 3 subgroups:THD+ hormone group (n=13),THD+ infliximab (IFX) group (n=12) and THD+ azathioprine (AZA) group (n=7);the induction remission rate,mucosa healing rate,occurrence of side effects and the severity of side effect in each group were evaluated and a comparative study was performed.Results The clinical remission rate in THD group,THD+hormone group,THD+ IFX group and THD+AZA group was 40.0％,53.8％,66.7％ and 71.4％ respectively;the mucosa healing rate in the 4 groups was 20.0％,23.1％,16.7 ％ and 28.6％ respectively;the occurrence of side effects in the 4 groups was 60.0％,92.3 ％,83.3 ％ and 71.4 ％ respectively.Conclusions In the application of combined regimen of low-dose THD,THD + IFX is of best curative effect without increasing the side effects of THD obviously;hormone and AZA can promote the curative effect of THD but will cause more side effects.